Healthcare Provider Details

I. General information

NPI: 1881065738
Provider Name (Legal Business Name): MIDWEST INSTITUTE OF NEUROLOGICAL DISCOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 01/19/2025
Certification Date: 01/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 LAKE COOK RD
DEERFIELD IL
60015-5242
US

IV. Provider business mailing address

440 LAKE COOK RD
DEERFIELD IL
60015
US

V. Phone/Fax

Practice location:
  • Phone: 847-945-6463
  • Fax: 847-945-6469
Mailing address:
  • Phone: 847-945-6463
  • Fax: 847-945-6469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVEN R DEVORE BEST
Title or Position: OWNNER/DIRECTOR/MANAGER
Credential: MD
Phone: 847-945-6463